August 30, 2023 • 47 mins
Our guest today has a three step process that will ensure that you’re paying as little as possible for your medical care! This is good to know because the leading cause of personal bankruptcy is… you guessed it, medical bills! An estimated 100 million Americans have amassed nearly $200 billion in medical debt, and nearly 1 in 5 adults have medical debt in collections according to a study by the Journal of the American Medical Association. And that’s why we’re happy to have Dr. Virgie Bright Ellington joining us today- as a doctor and an insurance executive, she has had an inside look at our broken healthcare system, and her book: Crush Medical Debt, outlines the steps that we need to take to ensure that we’re not paying money that we don’t owe. We discuss the most common medical bill ‘errors’, why it’s important to ask for CPT codes, what to do with the CPT codes once you have them, how to avoid getting outrageous bills to begin with, and much more today!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to How to Money. I'm Joel and I am Matt,
and today we're talking how to avoid and combat crushing
medical debt with doctor Virgie Ellington.
Speaker 2 (00:28):
Deest of the leading cause of personal bankruptcy is you
guessed it, medical bills. So when a singular expense like
this is such a blight on our personal finances, you
better believe that we're going to spend a minute on
how we can not only eliminate medical debt, but just
avoid it in the first place. So here are some
some more sobering statistics. And estimated one hundred million Americans
(00:51):
have amassed nearly two hundred billion dollars in medical debt,
and nearly one in five adults have medical debt that
is currently in collections. This is according to us study
by the Journal of the American Medical Association. And that
is why we're happy to have doctor Virgie Bright Ellington
joining us today on the pod. She obviously, I said doctor,
so she's an insider and her book Crushed Medical Debt.
(01:15):
It outlines the steps that we need to take to
ensure that we're not paying money that we don't owe
so we can avoid becoming one of those statistics. I
just mentioned earlier. So doctor Virgie, thank you so much
for joining us today on the podcast.
Speaker 3 (01:27):
You know what, thank you so much for having me guys.
It's awesome talking with you. Yeah.
Speaker 1 (01:31):
No, we're really excited for this conversation because I think
a lot of people might say bull ring, but Matt
just highlighted so many rings. Yes, it's like money.
Speaker 3 (01:40):
It is not boring exactly.
Speaker 1 (01:42):
And we like money, and we like keeping money in
our pockets, and this we want.
Speaker 3 (01:45):
To keep your money.
Speaker 1 (01:46):
Yes, this is a place where we get separated from
our money. So it's really important to talk about. But
the first question we have for everybody who comes on
the show is Matt and I we like to splurge
a little bit into here and now on a couple
things we enjoy. One of those things is craft beer,
even though I know you're a doctor and you might
say it's not the ideal choice, right, but that is
something we do enjoy. And moderation. What is that thing
(02:09):
you like to splour John in the here? Now? What
do you spend more money on in your personal life
while you're also still making wise choices for the future.
Speaker 3 (02:15):
I have to tell you, guys, it is sushi and
It's one of those things that sneaks up on you.
You write with any addiction, you don't realize you trouble
until something happens right is just matched in your face.
And I am just so thrilled and fortunate that my
favorite sushi place delivers and I'm just like doing my thing.
And then the day after Black Friday, so the day
(02:38):
after Thanksgiving one year, I order my sushi usual thing
and the guy, you know, just really sweet, you know,
kind guy with his usual smile, has in one hand
the sushi bag and then the other hand a big
giant bottle of sake. And it hit me. I was like,
I spend so much money with these folks, just like
(03:00):
they're like, okay, we're going to get in on, you know,
giving our best customers a big giant pressure. And that's
when I figured out, you know what, Virgie, you have
a problem. We're spending too much with a lot of
money on sushi.
Speaker 2 (03:14):
Okay, then quick follow up. Do you like the the
different roles that they make, you know, with the different ingredients,
or do you like the super fresh, high end cutting
meat there just on that perfectly formed piece of rice?
Speaker 3 (03:26):
You know what? I really I'm pretty predictable. I really
enjoy the salmon, that fresh salmon surrounded by carbs. You know,
there's just nothing like pure white rice carbs. It's also
a little bit of extra fat that mouth feel with
the avocados. So my thing right when I'm trying to
(03:47):
be healthy and be a good girl is the salmon
avocado role. But when I am being a bad girl,
I always have to get this shrimped tempearl with it fry.
Speaker 2 (03:59):
Oh yeah, be that so that's.
Speaker 3 (04:01):
Me they again, these guys have my order down cold.
Speaker 2 (04:04):
I love it. Yeah, that's so good. Speaking of that
rice that those cars, I've been trying to talk Joel
into getting the high end rice that they sell at Costco.
It's like three times the price of the cheaper stuff.
Speaker 1 (04:15):
But it's so much. But when you buy a back
in Costco, it's still last year, five years. You're still
exactly all.
Speaker 2 (04:21):
Right, doctor Virgie. Let's let's kind of dive into talking
about medical debt, and you know, like here on the podcast,
like I don't think there's much reason for us to
talk necessarily about like policy shortcomings and how this impacts
millions of folks across the country quite untimately, every year.
But given the lack of political will and output and
changes we've seen oftentimes seen that we were just left
(04:43):
to advocate for ourselves. Is that your experience and what
you've seen working with patients, This.
Speaker 3 (04:49):
Is the problem, guys. The issue is is that in
the United States, in order to have medical financial literacy,
you it's just it's really really people feel like it's
impossible to have. But in the United States, you have
to have medical financial literacy in order to have financial stability, period,
(05:12):
because most Americans, even those of us with fabulous insurance,
are just one accident or serious illness away from a
lifetime of debt or worse. And so people think, well,
we don't have any other choice. You know that we're
just stuck with this system, and it's an expensive system,
(05:32):
and it is what it is. No, that's the bad news.
The good news is, no, it doesn't have to be
this way. It doesn't have to be that way. So, no,
we have control over not getting taken advantage of. We
have control over not becoming victims to predatory billing. We
just don't know it. Ninety nine point nine percent of
(05:52):
us don't know it.
Speaker 1 (05:53):
I feel like we've all talked to somebody who says
I avoided going in to seek medical care because I
was worried about the financial repercussions of going in to
see the doctor or going to the hospital. And so
people will avoid getting the medical care they need sometimes
because they're scared of the financial outcome, which says a lot, right.
I mean, that's kind of scary stuff that people won't
(06:15):
get what they need, they won't see someone who can
help them with their problem because they're worried about how
much it's going to cost.
Speaker 3 (06:21):
You know, you guys are talking about the statistics at
the beginning the top of our conversation, and what's really
really sad and heartbreaking is scary, is that there's direct
relationship between having medical bills meaning medical debt meaning it's
a bill that you can't pay off in total at
the end of the month, and life span. So people
(06:43):
put off to your point, people put off getting care
because they can't afford it. They're afraid of the bill,
and something that could have been preventative maybe before the
issue started, or like screening type stuff or something that
was small gets really really huge and it's really expensive
and or can shorten your life. So it's real there
(07:03):
is a lot of statistics that bear this out, that
the American life span actually is shortened by debt.
Speaker 1 (07:10):
Well, and I mean that everybody's heard of the phrase
that an ounce of prevention is worth a pound of care.
Speaker 3 (07:15):
Right, if we just would And I always say, you know,
I tell my family this all the time. I say,
you know, not a pound of care. I say, worth
more than ten pounds of care. Ounce of prevention is
worth more than ten pounds of cure. It's just I
can't even begin to tell you believe that it's a
big deal. And you know, the student debt. I saw
(07:36):
you guys are talking about that the other week. The
student debt or student loan pause is ending, you know,
at the end of this month, so basically all of
the payments are now due again as of October first.
There's a study that came out last week that showed
those folks with student debt have lower health outcomes and
(07:58):
higher essentially medical more medical problems, and actually end up
having more medical bills because they're cutting back on other
things trying to make those student debt payments. So there's
a direct relationship between debt and destroyed families, destroyed lives,
and financial futures.
Speaker 2 (08:18):
Sure, and foregoing some of that care. That would be
the classic example of being cheap versus frugal, which we.
Speaker 3 (08:24):
Talk penny wise pound for sure exactly.
Speaker 2 (08:29):
Okay, So what you kind of I mean, you launched
into your book right like right out of the gate,
you kind of give some different case studies, and you
gave one where you were documenting basically signing an agreement
for these services before there was any services being provided.
So how common is this tactic? And you know, is
there a chance that if you are faced with one
(08:52):
of those and it feels like you're being pressured to
pay that, is there a chance that you would potentially
not receive care, you know, were you to actually refuse
signing one of those questions? How does that work?
Speaker 3 (08:59):
You know? And I laugh. I always say this. I
laugh so I don't cry. And that's how I got
into this work really literally was I had been a
internal medicine physician for god knows how many years, and
I was a health insurance executive, which gave me a
complete three hundred and sixty degree total view of the
(09:21):
US healthcare system and how it works, or so I thought,
until I became a patient and met Mia, my hospital roommate,
who told me she had been tripped into signing a
bill or agreement I should say to pay a bill
that I was pretty sure she didn't owe, but I
was definitely sure it was putting her and her family
(09:43):
into a lifetime of debt. The thing is is that
in an emergency situation, when you go into an emergency room, no,
you don't have to agree, you don't have to sign anything.
The care has to be provided to you until you
are stabilized. Once you're stabilized, they can ship you out
to someplace else that gives charity care or free care,
(10:04):
that kind of thing. My point to her was when
I was talking with her, she was telling me the
story about the last time she had been in the
hospital the year prior, and it was for the same thing.
She was being worked up, something happened, and they were
concerned doing these tests on her and kept her for
a week doing all these tests because they were concerned
that she was having a rare reaction of rare something.
(10:27):
And she was telling me that she was really concerned
about what this is going to cost this current hospitalization
because and she told me the story about yeah, when
this happened to me a year ago. One of the
hospital representatives came in and said, hey, before you can leave,
you need to sign this, and she explained, well, I
(10:50):
had insurance, I don't know what they were asking me
to sign. And guysa she was telling me the story,
I realized, oh my gosh, they tricked her into believing
that she had to sign to agree to be balance built.
And what that means is that if you have insurance,
if your provider a hospital in this case, is in
(11:11):
network with your insurance, it means they accept your insurance,
they have to take whatever the insurance pays them for
the services that they provide. So let's say that the
usual care for a service or service, the price for
a service that they offer is one hundred dollars. But
(11:31):
the insurance company says, well, if you want to be
a network with us and have access to our millions,
hundreds of thousands to millions of patients, then you know
you're going to have to accept this as payment and
full and we only pay like ten dollars for this service.
So that is a contract with between the provider with
the insurance company saying what they're going to take for
(11:55):
their members. For this particular insurance company as payment in full.
Balance billing is going back and saying, hey, yeah, you
know that service is reprovided for you. Your insurance only
paid ten dollars. We charge one hundred, so you owe
us ninety dollars.
Speaker 1 (12:13):
That's breaking balance that agreement right with the insurance company.
Speaker 3 (12:16):
That is essentially contract fraud because the person who is
agreed to the agreed the party that's been affected negatively
didn't sign a contract with them. The patients don't know that, hey,
this is balance billing. This is this is essentially contract
fraud between the insurance company and the provider.
Speaker 1 (12:38):
To talk to me about also just medical billing errors,
and there's I think you said in your book that
estimates are that ninety percent of medical bills contain errors.
So balance billing is an issue, but so is that
And so if we have insurance, are they finding and
pushing back against the errant bills that we're getting and
how can we find them in contest them if the
(12:59):
insurance isn't doing it.
Speaker 3 (13:00):
For us, well, the insurance company isn't going to know
that you're being balanced bill. Think about it. That's why
the providers are so ubiquitous and feel comfortable doing it,
because how is the insurance company going to know that
their provider that their network with balance built the patient, right,
They're never going to know. The insurance company isn't going
to see the bill that the provider sent you. That's
(13:23):
why it's so it's such an ubiquitous problem. Yes, to
answer your question, there are studies that say minimum eighty percent,
but up to ninety percent of all medical bills generated
in the United States have errors. And if you can imagine, guys,
they're not going to be in the favor of the patient, right,
They're going to be in the favor of the provider
(13:44):
and or the insurance company if you have insurance. So, yes,
it's a real thing. But this is a caveat, I say,
And in my experience, what I've seen is that these
quote unquote mistakes aren't really mistakes. I'm being generous by
calling the mistakes. And one of the top five mistakes
I talk about is balance billing. So the balance billing
(14:08):
we just discussed is one of the top five reasons
that eighty to ninety percent of us have been overcharged
with our medical care.
Speaker 1 (14:17):
So it's not in oops, it's intentional.
Speaker 3 (14:19):
Yeah, So let's say that we call you on it.
You know, we get this bill, Hey, you owe us
ninety dollars for that service that we charge one hundred
dollars for, but your insurance only pays ten. If I
call them up and say, hey, I'm looking I got
this bill from you guys, and I'm looking at this,
and it says that you're in network with my provider,
(14:40):
and I call with my insurance company. Rather, I call
my insurance company and they say, yes, you are in
network with them. By definition, in network means that you'll
take whatever they pay as payment in full for the
services that you that they cover. Okay, so where's this
ninety dollars coming from? This is I don't understand. And
(15:01):
they'll say, oh, gosh, you know what, our mistake, just
disregard them.
Speaker 2 (15:06):
Yeah, I didn't realize how big of an issue that was.
Balance billing. But in your book you talk about some
of the other common errors, and we're going to discuss
some of the ways that we can discover those errors,
and we will get some of that right after this break.
Speaker 1 (15:27):
All right, we're back from the break. We're still talking
about crushing medical debt, how to avoid it with doctor
Virgie Ellington and doctor Virgie. We're talking about the bill
you receive. Sometimes it's a balance bill that you should
have never received in the first place. And so the
way to combat that is to call and be like, hey,
call them out on their fake oops. Right, But let's
talk about some other stuff too, Like when we get
(15:49):
a bill that we do owe that the insurance doesn't
fully cover, Well, one, how do we know that it
is something that isn't fully taken care of by the
insurance company that we do actually owe, and then how
do we get to the bottom of Like you talk
about medical billing codes and it feels like it's this
completely new language that we have to learn if we
want to learn how to fight back against medical bills
(16:10):
in general, Like, how can we know what that system
entails and learn how to fight back against it.
Speaker 3 (16:16):
Yeah, So the way to figure this all out and
to not have to think, oh my gosh, what I
do now? What I do? What do I do and
not get overwhelmed is just understand there's only one right
way to pay any medical bill, and it involves three
simple steps. Step one, the key is CPT codes. CPT
(16:38):
codes are to medical services what bar codes are to
products in a retail store. So every medical service you
can think of getting in the United States has its
own unique CPT code. So every test, every operation, procedure, outpatient,
doctor visit, anything you can think of has its own
(16:59):
unique CEP codes. And that is the currency that is
saying okay, this is the service that was provided. This
is the common language between providers and payers. So if
you want to make sure that you're not getting overcharged,
get the CPT codes, meaning call the provider and ask
(17:21):
for a real bill with quote unquote CPT.
Speaker 1 (17:24):
Codes, and that's is that typically known as the itemized
bill as well, So that's.
Speaker 3 (17:29):
The language is played with. It's a game. So an
itemized bill. They'll say, yeah, sure, I'll send you an
item We'll send you an itemized bill and it'll have
all kinds of details of the things that they they're
charging you for the services you received, but they don't
have any CPT codes assigned to them. CPT codes are
usually about or usually five digits and at the top
(17:53):
of every bill if you scan it and it doesn't
have something at the top that says CPT or c
PT slash kicks picks hcpcs, which is a subtype of
CPT code, then it's not a real bill. There is
no insurance organization company in the country period that will
(18:14):
accept a bill that doesn't have CPT codes. Fly do
providers send insurance companies different bills, then they send patients
ninety nine points, I'd say nine times out of ten.
There are some hospitals that will send a real bill
the first time without having a call back and request one.
(18:34):
But if you call them and say I need an
itemize bill, they'll say, yeah, sure, and it makes them
very happy. They'll send you a very long list of
something that even says they'll have codes at the top
or service codes at the top, and it means nothing.
Speaker 1 (18:48):
Guys.
Speaker 3 (18:48):
It's language that's internal to that organization or to that
medical system. It is not a CPT code. That is
the common language that the providers and payers in the
United States speak for paying for medical care.
Speaker 1 (19:05):
Okay, So once we have those CPT codes for a
lot of people, it's going to feel like reading Latin,
going back to high school looking at a dead language
sort of thing. So what do we do with that
information once we have it in hand?
Speaker 3 (19:15):
So, yeah, now you finally have your bill, the real
bill that has CPT codes. And step two, you're going
to take each of those codes and you're going to
google what Medicare pays for each of those services. You're
actually why you're googling. You're doing two things. You're going
to plug in and let's use an example. I like
to use a lot CPT nine ninety two one three,
(19:38):
and that describes a type of outpatient office visit. You
plug that in, you do an Internet search, Google it,
and up will pop some descriptions of that code. And
what you're doing is basically just making sure it sounds
roughly like the services you believe that you were provider,
that you were told by your physician that you were
(19:58):
provided great, and while you're there, you're going to find
what Medicare pays for that CPT code, for each CPT
code for which you're being charged now Medicare. The reaction
I get Joel and Matt often is that people will say, well, Medicare,
(20:19):
that's for old people. That has nothing to do with me,
and I say, well, yeah it does, because Medicare is
the lowest, most fair retail price that is paid for
medical services in the United States period. So that's the
number you're looking for. That's the fair retail price you're
looking to pay. That's the price that shows you're not
(20:41):
being overcharged, overcharged, or upcharge. For instance, let's say you know,
God forbid, you had to go into the emergency room.
You're away a couple hours away skiing and you fell
broke your arm. Go to the nearest emergency room and
they're like, you know what they did the X rays.
You're going to need this set surgically. We'll call the
(21:03):
orthopedis closer to your home. You can go home. I'll
just put you in a sling here until you can
have surgery tomorrow or the day after near your home
with a provider near your home, or who's a network
with your insurance if you have insurance. So you go,
you go home, you get the surgery at the orthopedis
(21:23):
closest to your home, and a month later, you get
a bill and you from the emergency room right when
you're on vacation, and you look at it and you're like, well,
well no, there's no CPT codes here, So you call.
You finally get a real bill that has CPT codes
and you plug them in and one of the CPT
(21:44):
codes says humoral fracture intervention. So it sounds like well,
I don't know what humorous is, but fracture it sounds
like something broken. Okay, But intervention, well, all they did
was put it in a sling. No, they didn't do
an intervention. That's an up charge. There is a CPT
(22:05):
code I'm sure for a sling if they're going to
charge you for that, but they need to delineate that
in the CPT codes. They should not charge you for
fracture intervention. The intervention you had was at your home.
It was not in the emergency room. So that is
getting up charged. That's why you're going to take in
step two. Those CPT codes you work so hard to get.
(22:27):
In step one, google them, do an internet search, find
out what descriptions come up. Make sure it sounds roughly
like the services you had. To make sure you're not
getting double billed or up charged. And while you're there,
find out what the lowest, most fair retail price for
that medical see.
Speaker 2 (22:44):
Okay, so then you've got the procedure, you've got the
price is Step three just basically saying hey, this is
what I would like to pay.
Speaker 3 (22:50):
Yep, Matt and Joel, you guys are always putting ahead. Here,
you got it. Step three is calling back the provider
and saying, hey, yeah, you know that emergency her and
your surgery I have last month and I just got
a bill that the first bill you guys sent was
like ten thousand dollars. But in my case, I am
willing and able to pay three thousand dollars. And you're
(23:14):
not going to share this with you You don't have to
share this with them. It's not of their business and
they don't really care. But three thousand dollars is the
price that you may have come up with when you've
done the three steps against that medical bill. Medicare pays
three thousand dollars for the services you were billed ten
thousand dollars for in the initial bill that was not
(23:34):
a real bill. And you're going to say, you know what, yeah,
I can pay three thousand dollars, and you know what,
that was an emergency. Nobody's prepared for an emergency. I
can only look, you can't get blood out of a stone.
I've tried to turn my budget up every which way.
I can only get fifty dollars a month out of
(23:54):
my budget to pay this. Who can I speak with
who can help me set up an interest repayment plan
for this fifty dollars a month for this three thousand
dollars that I'm willing and able to pay. So Matt
and Joel. People also often when I get to this point,
when I share the example of the three steps, they'll say, well,
(24:15):
three thousand dollars fifty dollars a month, Oh my gosh,
even if they would accept that number, it's going to
take you forever. It will take you forever to pay that, Okay,
So it'll take you sixty months, five years, half a decade.
And the reason why they're going to accept it, it
doesn't matter how long it's going to take. That's what's
(24:36):
in your budget, and that's what you're gonna stick to.
You're gonna stick to your guns. And the reason why,
even though you're gonna get pushback, they've been trained to say, hey,
you know what, we took care of you and or
your loved ones during tough time and saved your life. Yeah,
you're gonna get your money. Yeah, guys, you'll get your money.
I just want to pay what I owe, and this
(24:56):
is what I can pay you, and they don't have
to chase you it costs them money to chase you.
Speaker 2 (25:01):
It's the burglar.
Speaker 3 (25:02):
They know they're saving money. That's why they're going to
accept you're being proactive. They don't have to chase you.
And frankly, they know that their bills are not real
bills to start with. That was a fake number to
start with.
Speaker 1 (25:17):
And if they have to turn it over to collections,
they're going to get pennies on the dollar.
Speaker 3 (25:20):
It's exactly.
Speaker 1 (25:22):
It's not gonna be worth their time.
Speaker 3 (25:23):
Probably right, you hit it right on the head.
Speaker 1 (25:25):
Well, okay, I want to ask you this, doctor Burgee,
because you reference somebody who even with like let's say
a bill of three thousand dollars, Hey, I don't have
the money to pay, and it's going to take me forever.
We can do a payment plan or something like that.
But maybe that's not even the place they need to go,
because what about what about qualifying for our financial assistance?
It seems like from what I've read, something like thirty
to forty percent of Americans, given their income and their
(25:47):
family size, could qualify will qualify for financial resistance either
a greatly reduced overall bill amount or for it to
be completely forgiven. Is that true?
Speaker 3 (25:57):
Yes, sir, you got it. It's true. So, by federal law,
all nonprofit institutions, hospital, medical service facilities, medical care facilities
have to offer to the folks in the communities in
which they operate sliding scale, income based discounts in exchange
for not paying any money in taxes, not paying a
(26:20):
dime in taxes for the hundreds of up to you know,
hundreds of millions of dollars of revenue. So that's a
big deal. By federal law, Yes, they must if there
are a nonprofit facility. And the last numbers I saw
about sixty sixty five percent of hospitals medical care facilities
in the United States are nonprofits. So yes, by federal
(26:41):
law they have to offer that. This is the thing.
Don't think that just because you have a high income
that you won't qualify. So I actually had a case
where the person had a really high income, like I
think her gross income salary was one hundred and fifty
thousand dollars a year, but our medical bill was so large,
(27:05):
I think it was like ten thousand dollars. According to
their formula for this facility, it was it happened to
be an academic facility, which are by definite. Usually I'd
say nine plus out of times out of ten. Their nonprofit,
this particular facility ten thousand dollars one hundred and fifty
thousand dollars growth salary, that sliding scale income based discount
(27:30):
wipe the whole bill away.
Speaker 1 (27:32):
Very nice, but they're not always going to tell you
that upfront, right, So you either have to like ask, hey,
what is your financial assistance policy?
Speaker 3 (27:41):
Exactly? Guys are so sharp. So by law, there's a
law that says they're supposed to post their practices for
offering a financial aid application. You can call it whatever
you call you know, whatever name you want to call it,
financial aid, financial assistance, charity care, whatever you want to
call it. They have to offer everyone an applicationation to
apply for sliding scale income based discounts. And so people think, again, oh,
(28:07):
I make too much money, and well I went to
this other hospital cross town and I didn't qualify. Every hospital, actually,
nonprofit facility even in the same town, have different formulas.
So always always ask. So someone brought this up instead
of doing the three steps, just ask for a sliding
(28:27):
scale income based application, ask for financial aid assistance application.
This is the problem. If you do the math if
you're saying about thirty to forty percent of medical services,
meaning medical bills you're going to get in this country
qualify for required financial aid required federal financial aid by
(28:51):
the government. So that means that sixty percent seven sixty
to seventy percent of the medical bills generating these in
the United States do not qualify for required financial aid.
So you want to do both. So what I usually
do is in those cases, if you know that you
went to a facility that as a nonprofit facility or
(29:15):
an academic facility, ask call theer billing office and ask
for a financial aid application. Once you get the bill,
then you can find out what you owe. If you
have the whole thing wiped away, they don't have to
bother to apply the three steps. But if there's any
money left over, or they don't offer financial lead, or
you don't qualify, then you know the three steps to
(29:37):
make sure that you are getting the You're not i
should say, getting overcharged, you're getting the right bill.
Speaker 2 (29:44):
It's a multi pronged approach, and I think that that's
a great way to think about it. But once you do,
I mean what you're talking about there, once you get
the bill let's say you've kind of passed the stage
where you can apply for that financial assistance. What you're
talking about there is negotiating for it. And one of
the things that you talk about your book to aid
within that discussion that negotiation is what you call a
quote unquote battle journal, which sounds really intense, but I
(30:08):
feel like it also doesn't have to be the super
confrontational thing. It can even just like basically, what you're
doing is you're just trying to provide some organization to
your thoughts. You're trying to provide some organization to discussions
that you've had, Who you've talked to, what date you
had that discussion, what it is that you've learned. I
guess I'm kind of explaining why that's why that's so
important as well, But yeah, I mean, why why else
(30:29):
do you need to have a record of some of
your conversations.
Speaker 3 (30:33):
Yeah, people think that negotiating in whilst something that's aggressive,
or that you have to know fancy words or no
fancy medical terms or be really really smart. No, when
you're doing the three steps, you're automatically negotiating. You just
(30:53):
it's just very matter of fact. It's just going through
the steps and when you call.
Speaker 2 (30:57):
Them surprise you're negotiating. Yeah, you don't eize, you.
Speaker 3 (31:01):
Know, you don't realize that, Hey, I have this hard
number here. They're like, okay, fifty dollars is going to
take us forever to get our money. Can you do
one hundred? No, no, you can't. And let me tell
you why. You're going to stand on your ground again.
If you agreed to one hundred, you're like, okay, maybe
I can squeeze and stretch to one hundred. If you
have a bad month and you can't make that hundred
dollars payment that you agreed to, they can send you
(31:24):
to collections right away. So stick to your guns. Whatever
your number that you come up with, you have to
stick to it. So that's why you want to use
a battle journal. And I felt kind of bad to
your guys's point, I felt kind of bad calling at
a battle journal, But that's what it is. It's kind
of like armor for you because you are documenting every
(31:45):
discussion you have with them. And unfortunately, if something happens
and they try to take you to collection, send you
to collections or god wd, be even worse, you know,
bring a claim against you in court, you have documentation
of who you spoke with and what was said.
Speaker 1 (32:01):
Okay, I want to ask you about best payment method. So,
for instance, let's say you come to an agreement, you say,
all right, I got the CPT codes. I push back,
and now the true bill instead of ten thousand dollars
is eighteen hundred dollars, and I don't qualify for financial assistance,
so I've got to pay it. But I also don't
have eighteen hundred dollars. Some people will just put it
(32:23):
on the credit card to be done with it, paying
interest for months and months and maybe even years to come,
really harming their personal finances and their future. So how
should people pay? How do you agree to pay the
hospital when there is a certain amount you owe and
you feel comfortable now with the final bill, how do
you proceed?
Speaker 3 (32:42):
Yes, you do not want to put it on a
credit card, no matter what. And that's because once you
put it on a credit card, a medical bill on
a credit card, you automatically obliterate all of the federal
protections federal law, legal protections that you have to have
medical debt not show up on your FYCAL score. So
(33:05):
when you make an agreement a payment plan directly with
the facility. I call it, you know, dancing with the
ones that brought you to the party. Keep your medical
bill with the people that provided their service. You want
to do that, because medical bill payments or payment plans,
I should say that are made directly with the provider
don't show up on your fical score. And to your
(33:28):
earlier point, yes, The second issue is once you put
something in a credit card, if you can't make pay
it all off, the interest rates and by the way,
medical or they call them care credit cards are the
same thing. They say, oh, well, we charge you zero
interest for two years. I think I saw one last
year that has like three years of zero percent interest.
(33:49):
If you make the payments and pay it all off.
Well what if you can't. If something happens and you can't,
there you go and those interest rates rack up fast.
Speaker 1 (33:58):
No that makes sense. Okay, well that's great advice. We've
got a few more questions we want to get to
with you, doctor Virgie, including kind of where we go
for help if we're stonewalled with a bureaucracy at a
hospital or a medical facility. We'll get to questions about
that with you right after this.
Speaker 2 (34:22):
We are back. We're talking with doctor Virgie on how
to avoid this crushing medical debt. And before the break,
Joel alluded to this, but are there any government or
nonprofit agencies that can help if we feel like we're
being given the run around, if it doesn't feel like
that we're being given the right information, what can we
do about it?
Speaker 3 (34:43):
So, if you received your care at a nonprofit hospital,
there is a nonprofit organization called Dollar furdal l l
A r f o R dot org and they will
help you work through the process of appealing essentially the
(35:03):
decisions by this facility to not cover you lower your
bill or they say that the care is this price
and not the price that you in your research applying
the three steps discovered with the medicare fair retail price.
So that's one organization there. The organization that I always
(35:25):
refer folks to that's also a nonprofit, will help you
with all medical bills, it doesn't matter if it was
with a nonprofit hospital, and that's called the Patient Advocate
Foundation and that's Patient Advocate dot org. And the reason
why I recommend them is because basically they do almost everything.
(35:47):
They do everything other than up to not including going
with you and representing you in court if you get
taken to court by these unscrupulous, over aggressive predatory providers.
Now there are some for profit companies that will do this.
They'll help negotiate bills down and in exchange they take
(36:07):
ten percent usually as the going number of the amount
that they save you. So I saw one case where
the insurance company refused to pay the eighty thousand dollars
NICK bill for twins because in their records they said
(36:28):
it was not an emergency. Well, when is babies being
born ever? Not an emergency like the right? And they
were sick they needed to go to a NICK So
how is that? How was that elective? Right? So, anyway,
the point is the couple tried to go for months
(36:48):
in between the providers and the insurance company, and just
the conversation and the information and medical rectors weren't getting
passed along. So they got tired. It's a war of attrition, guys.
That's why I called a battle journal. It's real, it's really.
They just wore them down, and so they finally went
to a for profit company that helps resolve these issues.
(37:08):
And so instead of paying eighty thousand dollars, they paid
eight thousand dollars to the company that negotiated the bill down.
Speaker 1 (37:16):
Okay, Yeah, I've seen some of these popping up, and
it seems like for the person who's gotten weary finding
that bill, it might be a decent kind of last solution, right, And.
Speaker 3 (37:26):
I really disagree. Now, if you're really chronically only has
some really big major medical issues and hospitalizations prolonged and
multiple Okay, yeah, but then I would recommend hey reach
out to just try the Patient Advocate Foundation first. But
the first thing I want everybody to know is that
a lot of this foolishness can be just be just
(37:47):
just not become a non issue if you just apply
the three steps.
Speaker 1 (37:52):
Yeah, okay, say that.
Speaker 3 (37:54):
Eight thousand dollars, eight thousand dollars supposed a long way
to a college fund, starting a college fund for twins.
Speaker 1 (38:00):
Right, that's a lot of money too, And we don't
want any how to money listeners paying any dollars more
than they have to be.
Speaker 3 (38:06):
You don't, Oh, that's my point. If you don't know
what no, all.
Speaker 1 (38:10):
Right, you mentioned at the very beginning of your book,
you say that a portion of the sales proceeds go
to this nonprofit called RIP Medical debt, which Matt and
I we've heard of. They have what I think they've
eradicated over a billion dollars maybe.
Speaker 3 (38:22):
Oh gosh, that was last year. Just in lessen a year, guys,
they've gone from over a billion dollars to over seven
billion with a b dollars and medical bills are eradicated
for folks facing bankruptcy from these medical bills.
Speaker 1 (38:37):
And these are all right, these are all medical bills
that have gone to collections and then and then RIP
Medical Debt is saying, listen, for pennies on the dollar,
we're going to eradicate this on behalf of people. So
it feels like it should be something that's unnecessary in
a country like ours, but sadly it's necessary. But I'm
also I think it's great that what you're doing with
part of the proceeds of your book is going to
(38:58):
help ensure that their work continues to to you know,
continue continues to make waves out in the world.
Speaker 3 (39:04):
So for every book that sold, one dollar goes to
our IP Medical Debt, which eradicates one hundred dollars in
medical bills for someone facing bankruptcy from bills medical bills
that have gone to collections.
Speaker 2 (39:18):
Very cool. We love that, We love that that that
is a part of your mission, doctor Virgie. And we
haven't even gotten to everything obviously that you cover in
your book, and so we will link to where it
is that folks can purchase your book, and actually, can
you tell us where it is folks can learn more
about you?
Speaker 3 (39:34):
Sure? Well, first, why don't you just like have me
come back? What's just no part way guys, But if
you want to find out more, Crush medical debt dot
com is the place to start. And I'd like to
send people to Crush Medical debt dot com slash free
dash resources or just go to Crush Medical Debt dot
(39:55):
com and the free resources as on the top of
the navbar there. And the reason is I direct folks
there because that's where you can find a refresher a
checklist of the three steps of the Only Right Way
to Pay every medical bill. So, you know, some people say,
you know what, I really don't even want to spend
money on a book. I've just things are just so tight,
(40:16):
I just know, So go to crushmedical debt dot com
get this information for free, the three steps of the
Only Right Way to Pay a Medical Bill and I'd
say eight to nine times out of ten. You just
eradicate the foolishness that unfortunately predatory billing tries to inflict
on folks and make us victims of the system.
Speaker 1 (40:36):
Doctor Burgie. We love what you're doing out there. You're
making a difference, and thank you so much for joining
us on the show today.
Speaker 3 (40:42):
Oh my gosh, thank you for having me guys. I
love talking with you, and thank you for what you
guys do. You're doing awesome stuff helping folks master their money.
Speaker 1 (40:49):
Oh well, thank you. Like you're in a kind similar
missions I think, like minded for sure.
Speaker 3 (40:54):
Yeah, mutual admiration society.
Speaker 1 (40:58):
Awesome. Well, thanks again, Take care guys, Matt. Always good
to have a swell conversation. There's so much, so much
nuance in this topic of pushing back against you know,
unethical medical billing is sure is one thing, or maybe
just an error prone industry as on top of that,
and there's there's a lot we need to know as
individuals to fight back.
Speaker 2 (41:18):
She mentioned how they never make mistakes in your favor.
Speaker 1 (41:21):
Right, isn't that amazing?
Speaker 2 (41:23):
So if you are out there and you're thinking, oh,
I don't think I want to check in because what
if I'm actually going to owe them more money? That's high,
highly unlikely.
Speaker 1 (41:33):
You never like that community chest of monopoly, right, bank
are in your favor, here's one hundred and fifty bucks.
It's not gonna happen.
Speaker 2 (41:39):
But yeah, what was your big takeaway from our conversation
with doctor Vergie?
Speaker 1 (41:42):
Okay? I think my big takeaway was to use technology
to your advantage. And she was talking about, well, one,
just pushing back getting those those CPT codes, But on
top of that, she was saying, use Google, right, and
Google can help you not only figure out what those
codes mean because it's like a foreign language, but on
out of that you can figure out what is medicare,
(42:02):
pay these medical facilities right for those codes for those services.
And without the Internet and Google at your service, man,
this must have been so much harder back in the day.
Speaker 2 (42:13):
I think it was probably impossible. Yeah, yeah, So.
Speaker 1 (42:15):
It's nice back in the day, nice to know that
you've got technology on your side. There's a lot of
information out there. It's not necessarily right there in front
of your face. You have to dig a little bit,
but a little bit of digging can save.
Speaker 2 (42:25):
You a lot. Yeah, absolutely, and that's important. Information to know.
And so you were talking about figuring out what it
is that Medicare pays. So I guess my big takeaway
is going to be related to that, because obviously it's
not that you're trying to get out from paying a
bill where a hospital or a doctor took care of
you and provided you a good service. You just want
to in what she said and when I wrote this down,
(42:46):
but you want to be able to pay the fair
retail value. And you know what if the government, if
they're the ones saying that, oh, this is a fair price,
well I want that to be a fair price for
me as well, like I don't't have to pay some
marked up right. And so it's not that you're trying
to pull one on the hospital or the doctor or
the clinic or wherever. It's just about making sure that
(43:06):
you're not getting ripped off. And so I guess it's
not just about having the tools and using the technology
and figuring out the CPT codes. But it's not not GPT.
By the way, we're not talking about chat chat CPTs.
Somebody should make a tool.
Speaker 1 (43:21):
That's chat cpt A I can help you push back
on some of this.
Speaker 2 (43:25):
Yeah, that's so so it's not just about the tools,
it's also the mindset and how it is that you
are looking to approach some of these conversations in some
of these negotiations, because if you are not afraid, but
if you're kind of timid about how it is you're
talking to these medical providers, you may not negotiate as well.
If you're thinking, well, they did fix me.
Speaker 1 (43:46):
Yeah, you might think, oh, I got good service. The
doctors and the nurses were great, Like, I guess I
have to pay what I owe, but you should as
opposed to divorce those two things. Thankful for the great service,
but then push back against the bill that's out of line.
And there are specific lines in this that you can
draw based on the information you can get from the
internet from just a little.
Speaker 2 (44:04):
Bit of research.
Speaker 1 (44:04):
So you don't have to feel bad pushing back, especially
because these nonprofit hospitals in particular, have a lot of discretion,
have a lot of ability thought for forgiveness, and actually
legally are required to So yeah.
Speaker 2 (44:16):
Well, she was saying that that's another great point that
I guess I'd never really thought about it, but that
they are required to offer what the an income based
repayment plan. Oh my gosh, that's also some excellent information
to have on hand, Like, these are all things that
should help you to think. Oh no, I don't want
to say that you are owed a discount or that
(44:36):
you deserve a discount, but that is one hundred percent
an option. Yeah, especially if you're like, wait a minute,
I get taxed on what I earn the hospital doesn't
so a little bit.
Speaker 1 (44:47):
I've done this before too, and before I knew that
this is the reason why it was forgiving.
Speaker 2 (44:50):
Them just because I want to save money, like pay
less money.
Speaker 1 (44:52):
I was like naive but just kind of persistent, and
having looked back on those days, I'm like, man, it's
just interesting. I've probably paid other medical bills that I
didn't need to, and I don't want other people to
go through that. I want people to be able to
know their rights, know how they can push back and
get their bills either reduced or forgiven, and fight back
(45:13):
against a system that is really seeking to part them
from their money.
Speaker 2 (45:16):
Yeah, to feel empowered and motivated to do it as well. Yeah,
that's right man. All right. The beer that you and
I we both each enjoyed, a Passo fino porter. This
is a beer by Horsefly Brewing Company out of Montrose.
Is it Montrose? I don't know, it's one word, but
it's it's Montrose, but just one word in Colorado. But
(45:39):
this is a beer from Mark and Caitlin. And so
they actually live in North Carolina and they embarked on this,
he said, eighty six hundred mile road trip that included
a couple of days. Nice.
Speaker 1 (45:51):
I guess at a favorite spot of every road trip
needs to involve a craft brewery or it's not officially
a road trip. Sorry, you just drove your car around
the country, all right, True, you gotta have disc golf,
I think, and craft beer involves. But yeah, big thanks
to him taking that's a Yeah, that's gonna be interesting
Mark and Caitlin, big thanks to y'all. And yeah, this
beer was. It reminded me of like did you dig
get a semi sweet chocolate chip where it was a
(46:11):
little bit bitter, a little bit sweet and not too heavy, right,
So I love a good porter and too heavy.
Speaker 2 (46:18):
Yeah, too sweet, which is kind of exactly what you
want on a warmer summer day like we're experiencing now, right.
Speaker 1 (46:24):
So you get that it's not stout weather yet, No, yeah,
we can do porters.
Speaker 2 (46:27):
If you want some of that roasty flavor, then that's
when you should be looking to something like a porter
where you've got those darker flavors without the body that
weighs you down. That feels like it should. You know,
it's almost like a blanket. You want a nice heavy
blanket in the winter. That's also how I feel about
bigger scouts. If you do what some of that flavor
here in these warmer months, that's when you offer that porter.
Speaker 1 (46:47):
Yeah, the big stouts are December through February. That's absolutely yeah.
Speaker 2 (46:51):
But then again, you know, we'll probably end up with
us some giant stout in like two weeks while it's
still warm.
Speaker 1 (46:56):
You never know. We are equal opportunity drinkers. But that'll
be the that'll be it for this episode. We'll have
links to some of the free resources that doctor Burgie
mentioned up in our show notes at how money dot
com and a link to her book to so you
can check that out.
Speaker 2 (47:08):
Yea, specifically the patient Advocate dot org. That's sounding like
an incredible, incredible site. For sure, you can find all
that up there. But buddy, that's going to be it
for this one. So until next time, best friends out,
best friends out
Welcome to How to Money. I'm Joel and I am Matt,
and today we're talking how to avoid and combat crushing
medical debt with doctor Virgie Ellington.
Speaker 2 (00:28):
Deest of the leading cause of personal bankruptcy is you
guessed it, medical bills. So when a singular expense like
this is such a blight on our personal finances, you
better believe that we're going to spend a minute on
how we can not only eliminate medical debt, but just
avoid it in the first place. So here are some
some more sobering statistics. And estimated one hundred million Americans
(00:51):
have amassed nearly two hundred billion dollars in medical debt,
and nearly one in five adults have medical debt that
is currently in collections. This is according to us study
by the Journal of the American Medical Association. And that
is why we're happy to have doctor Virgie Bright Ellington
joining us today on the pod. She obviously, I said doctor,
so she's an insider and her book Crushed Medical Debt.
(01:15):
It outlines the steps that we need to take to
ensure that we're not paying money that we don't owe
so we can avoid becoming one of those statistics. I
just mentioned earlier. So doctor Virgie, thank you so much
for joining us today on the podcast.
Speaker 3 (01:27):
You know what, thank you so much for having me guys.
It's awesome talking with you. Yeah.
Speaker 1 (01:31):
No, we're really excited for this conversation because I think
a lot of people might say bull ring, but Matt
just highlighted so many rings. Yes, it's like money.
Speaker 3 (01:40):
It is not boring exactly.
Speaker 1 (01:42):
And we like money, and we like keeping money in
our pockets, and this we want.
Speaker 3 (01:45):
To keep your money.
Speaker 1 (01:46):
Yes, this is a place where we get separated from
our money. So it's really important to talk about. But
the first question we have for everybody who comes on
the show is Matt and I we like to splurge
a little bit into here and now on a couple
things we enjoy. One of those things is craft beer,
even though I know you're a doctor and you might
say it's not the ideal choice, right, but that is
something we do enjoy. And moderation. What is that thing
(02:09):
you like to splour John in the here? Now? What
do you spend more money on in your personal life
while you're also still making wise choices for the future.
Speaker 3 (02:15):
I have to tell you, guys, it is sushi and
It's one of those things that sneaks up on you.
You write with any addiction, you don't realize you trouble
until something happens right is just matched in your face.
And I am just so thrilled and fortunate that my
favorite sushi place delivers and I'm just like doing my thing.
And then the day after Black Friday, so the day
(02:38):
after Thanksgiving one year, I order my sushi usual thing
and the guy, you know, just really sweet, you know,
kind guy with his usual smile, has in one hand
the sushi bag and then the other hand a big
giant bottle of sake. And it hit me. I was like,
I spend so much money with these folks, just like
(03:00):
they're like, okay, we're going to get in on, you know,
giving our best customers a big giant pressure. And that's
when I figured out, you know what, Virgie, you have
a problem. We're spending too much with a lot of
money on sushi.
Speaker 2 (03:14):
Okay, then quick follow up. Do you like the the
different roles that they make, you know, with the different ingredients,
or do you like the super fresh, high end cutting
meat there just on that perfectly formed piece of rice?
Speaker 3 (03:26):
You know what? I really I'm pretty predictable. I really
enjoy the salmon, that fresh salmon surrounded by carbs. You know,
there's just nothing like pure white rice carbs. It's also
a little bit of extra fat that mouth feel with
the avocados. So my thing right when I'm trying to
(03:47):
be healthy and be a good girl is the salmon
avocado role. But when I am being a bad girl,
I always have to get this shrimped tempearl with it fry.
Speaker 2 (03:59):
Oh yeah, be that so that's.
Speaker 3 (04:01):
Me they again, these guys have my order down cold.
Speaker 2 (04:04):
I love it. Yeah, that's so good. Speaking of that
rice that those cars, I've been trying to talk Joel
into getting the high end rice that they sell at Costco.
It's like three times the price of the cheaper stuff.
Speaker 1 (04:15):
But it's so much. But when you buy a back
in Costco, it's still last year, five years. You're still
exactly all.
Speaker 2 (04:21):
Right, doctor Virgie. Let's let's kind of dive into talking
about medical debt, and you know, like here on the podcast,
like I don't think there's much reason for us to
talk necessarily about like policy shortcomings and how this impacts
millions of folks across the country quite untimately, every year.
But given the lack of political will and output and
changes we've seen oftentimes seen that we were just left
(04:43):
to advocate for ourselves. Is that your experience and what
you've seen working with patients, This.
Speaker 3 (04:49):
Is the problem, guys. The issue is is that in
the United States, in order to have medical financial literacy,
you it's just it's really really people feel like it's
impossible to have. But in the United States, you have
to have medical financial literacy in order to have financial stability, period,
(05:12):
because most Americans, even those of us with fabulous insurance,
are just one accident or serious illness away from a
lifetime of debt or worse. And so people think, well,
we don't have any other choice. You know that we're
just stuck with this system, and it's an expensive system,
(05:32):
and it is what it is. No, that's the bad news.
The good news is, no, it doesn't have to be
this way. It doesn't have to be that way. So, no,
we have control over not getting taken advantage of. We
have control over not becoming victims to predatory billing. We
just don't know it. Ninety nine point nine percent of
(05:52):
us don't know it.
Speaker 1 (05:53):
I feel like we've all talked to somebody who says
I avoided going in to seek medical care because I
was worried about the financial repercussions of going in to
see the doctor or going to the hospital. And so
people will avoid getting the medical care they need sometimes
because they're scared of the financial outcome, which says a lot, right.
I mean, that's kind of scary stuff that people won't
(06:15):
get what they need, they won't see someone who can
help them with their problem because they're worried about how
much it's going to cost.
Speaker 3 (06:21):
You know, you guys are talking about the statistics at
the beginning the top of our conversation, and what's really
really sad and heartbreaking is scary, is that there's direct
relationship between having medical bills meaning medical debt meaning it's
a bill that you can't pay off in total at
the end of the month, and life span. So people
(06:43):
put off to your point, people put off getting care
because they can't afford it. They're afraid of the bill,
and something that could have been preventative maybe before the
issue started, or like screening type stuff or something that
was small gets really really huge and it's really expensive
and or can shorten your life. So it's real there
(07:03):
is a lot of statistics that bear this out, that
the American life span actually is shortened by debt.
Speaker 1 (07:10):
Well, and I mean that everybody's heard of the phrase
that an ounce of prevention is worth a pound of care.
Speaker 3 (07:15):
Right, if we just would And I always say, you know,
I tell my family this all the time. I say,
you know, not a pound of care. I say, worth
more than ten pounds of care. Ounce of prevention is
worth more than ten pounds of cure. It's just I
can't even begin to tell you believe that it's a
big deal. And you know, the student debt. I saw
(07:36):
you guys are talking about that the other week. The
student debt or student loan pause is ending, you know,
at the end of this month, so basically all of
the payments are now due again as of October first.
There's a study that came out last week that showed
those folks with student debt have lower health outcomes and
(07:58):
higher essentially medical more medical problems, and actually end up
having more medical bills because they're cutting back on other
things trying to make those student debt payments. So there's
a direct relationship between debt and destroyed families, destroyed lives,
and financial futures.
Speaker 2 (08:18):
Sure, and foregoing some of that care. That would be
the classic example of being cheap versus frugal, which we.
Speaker 3 (08:24):
Talk penny wise pound for sure exactly.
Speaker 2 (08:29):
Okay, So what you kind of I mean, you launched
into your book right like right out of the gate,
you kind of give some different case studies, and you
gave one where you were documenting basically signing an agreement
for these services before there was any services being provided.
So how common is this tactic? And you know, is
there a chance that if you are faced with one
(08:52):
of those and it feels like you're being pressured to
pay that, is there a chance that you would potentially
not receive care, you know, were you to actually refuse
signing one of those questions? How does that work?
Speaker 3 (08:59):
You know? And I laugh. I always say this. I
laugh so I don't cry. And that's how I got
into this work really literally was I had been a
internal medicine physician for god knows how many years, and
I was a health insurance executive, which gave me a
complete three hundred and sixty degree total view of the
(09:21):
US healthcare system and how it works, or so I thought,
until I became a patient and met Mia, my hospital roommate,
who told me she had been tripped into signing a
bill or agreement I should say to pay a bill
that I was pretty sure she didn't owe, but I
was definitely sure it was putting her and her family
(09:43):
into a lifetime of debt. The thing is is that
in an emergency situation, when you go into an emergency room, no,
you don't have to agree, you don't have to sign anything.
The care has to be provided to you until you
are stabilized. Once you're stabilized, they can ship you out
to someplace else that gives charity care or free care,
(10:04):
that kind of thing. My point to her was when
I was talking with her, she was telling me the
story about the last time she had been in the
hospital the year prior, and it was for the same thing.
She was being worked up, something happened, and they were
concerned doing these tests on her and kept her for
a week doing all these tests because they were concerned
that she was having a rare reaction of rare something.
(10:27):
And she was telling me that she was really concerned
about what this is going to cost this current hospitalization
because and she told me the story about yeah, when
this happened to me a year ago. One of the
hospital representatives came in and said, hey, before you can leave,
you need to sign this, and she explained, well, I
(10:50):
had insurance, I don't know what they were asking me
to sign. And guysa she was telling me the story,
I realized, oh my gosh, they tricked her into believing
that she had to sign to agree to be balance built.
And what that means is that if you have insurance,
if your provider a hospital in this case, is in
(11:11):
network with your insurance, it means they accept your insurance,
they have to take whatever the insurance pays them for
the services that they provide. So let's say that the
usual care for a service or service, the price for
a service that they offer is one hundred dollars. But
(11:31):
the insurance company says, well, if you want to be
a network with us and have access to our millions,
hundreds of thousands to millions of patients, then you know
you're going to have to accept this as payment and
full and we only pay like ten dollars for this service.
So that is a contract with between the provider with
the insurance company saying what they're going to take for
(11:55):
their members. For this particular insurance company as payment in full.
Balance billing is going back and saying, hey, yeah, you
know that service is reprovided for you. Your insurance only
paid ten dollars. We charge one hundred, so you owe
us ninety dollars.
Speaker 1 (12:13):
That's breaking balance that agreement right with the insurance company.
Speaker 3 (12:16):
That is essentially contract fraud because the person who is
agreed to the agreed the party that's been affected negatively
didn't sign a contract with them. The patients don't know that, hey,
this is balance billing. This is this is essentially contract
fraud between the insurance company and the provider.
Speaker 1 (12:38):
To talk to me about also just medical billing errors,
and there's I think you said in your book that
estimates are that ninety percent of medical bills contain errors.
So balance billing is an issue, but so is that
And so if we have insurance, are they finding and
pushing back against the errant bills that we're getting and
how can we find them in contest them if the
(12:59):
insurance isn't doing it.
Speaker 3 (13:00):
For us, well, the insurance company isn't going to know
that you're being balanced bill. Think about it. That's why
the providers are so ubiquitous and feel comfortable doing it,
because how is the insurance company going to know that
their provider that their network with balance built the patient, right,
They're never going to know. The insurance company isn't going
to see the bill that the provider sent you. That's
(13:23):
why it's so it's such an ubiquitous problem. Yes, to
answer your question, there are studies that say minimum eighty percent,
but up to ninety percent of all medical bills generated
in the United States have errors. And if you can imagine, guys,
they're not going to be in the favor of the patient, right,
They're going to be in the favor of the provider
(13:44):
and or the insurance company if you have insurance. So, yes,
it's a real thing. But this is a caveat, I say,
And in my experience, what I've seen is that these
quote unquote mistakes aren't really mistakes. I'm being generous by
calling the mistakes. And one of the top five mistakes
I talk about is balance billing. So the balance billing
(14:08):
we just discussed is one of the top five reasons
that eighty to ninety percent of us have been overcharged
with our medical care.
Speaker 1 (14:17):
So it's not in oops, it's intentional.
Speaker 3 (14:19):
Yeah, So let's say that we call you on it.
You know, we get this bill, Hey, you owe us
ninety dollars for that service that we charge one hundred
dollars for, but your insurance only pays ten. If I
call them up and say, hey, I'm looking I got
this bill from you guys, and I'm looking at this,
and it says that you're in network with my provider,
(14:40):
and I call with my insurance company. Rather, I call
my insurance company and they say, yes, you are in
network with them. By definition, in network means that you'll
take whatever they pay as payment in full for the
services that you that they cover. Okay, so where's this
ninety dollars coming from? This is I don't understand. And
(15:01):
they'll say, oh, gosh, you know what, our mistake, just
disregard them.
Speaker 2 (15:06):
Yeah, I didn't realize how big of an issue that was.
Balance billing. But in your book you talk about some
of the other common errors, and we're going to discuss
some of the ways that we can discover those errors,
and we will get some of that right after this break.
Speaker 1 (15:27):
All right, we're back from the break. We're still talking
about crushing medical debt, how to avoid it with doctor
Virgie Ellington and doctor Virgie. We're talking about the bill
you receive. Sometimes it's a balance bill that you should
have never received in the first place. And so the
way to combat that is to call and be like, hey,
call them out on their fake oops. Right, But let's
talk about some other stuff too, Like when we get
(15:49):
a bill that we do owe that the insurance doesn't
fully cover, Well, one, how do we know that it
is something that isn't fully taken care of by the
insurance company that we do actually owe, and then how
do we get to the bottom of Like you talk
about medical billing codes and it feels like it's this
completely new language that we have to learn if we
want to learn how to fight back against medical bills
(16:10):
in general, Like, how can we know what that system
entails and learn how to fight back against it.
Speaker 3 (16:16):
Yeah, So the way to figure this all out and
to not have to think, oh my gosh, what I
do now? What I do? What do I do and
not get overwhelmed is just understand there's only one right
way to pay any medical bill, and it involves three
simple steps. Step one, the key is CPT codes. CPT
(16:38):
codes are to medical services what bar codes are to
products in a retail store. So every medical service you
can think of getting in the United States has its
own unique CPT code. So every test, every operation, procedure, outpatient,
doctor visit, anything you can think of has its own
(16:59):
unique CEP codes. And that is the currency that is
saying okay, this is the service that was provided. This
is the common language between providers and payers. So if
you want to make sure that you're not getting overcharged,
get the CPT codes, meaning call the provider and ask
(17:21):
for a real bill with quote unquote CPT.
Speaker 1 (17:24):
Codes, and that's is that typically known as the itemized
bill as well, So that's.
Speaker 3 (17:29):
The language is played with. It's a game. So an
itemized bill. They'll say, yeah, sure, I'll send you an
item We'll send you an itemized bill and it'll have
all kinds of details of the things that they they're
charging you for the services you received, but they don't
have any CPT codes assigned to them. CPT codes are
usually about or usually five digits and at the top
(17:53):
of every bill if you scan it and it doesn't
have something at the top that says CPT or c
PT slash kicks picks hcpcs, which is a subtype of
CPT code, then it's not a real bill. There is
no insurance organization company in the country period that will
(18:14):
accept a bill that doesn't have CPT codes. Fly do
providers send insurance companies different bills, then they send patients
ninety nine points, I'd say nine times out of ten.
There are some hospitals that will send a real bill
the first time without having a call back and request one.
(18:34):
But if you call them and say I need an
itemize bill, they'll say, yeah, sure, and it makes them
very happy. They'll send you a very long list of
something that even says they'll have codes at the top
or service codes at the top, and it means nothing.
Speaker 1 (18:48):
Guys.
Speaker 3 (18:48):
It's language that's internal to that organization or to that
medical system. It is not a CPT code. That is
the common language that the providers and payers in the
United States speak for paying for medical care.
Speaker 1 (19:05):
Okay, So once we have those CPT codes for a
lot of people, it's going to feel like reading Latin,
going back to high school looking at a dead language
sort of thing. So what do we do with that
information once we have it in hand?
Speaker 3 (19:15):
So, yeah, now you finally have your bill, the real
bill that has CPT codes. And step two, you're going
to take each of those codes and you're going to
google what Medicare pays for each of those services. You're
actually why you're googling. You're doing two things. You're going
to plug in and let's use an example. I like
to use a lot CPT nine ninety two one three,
(19:38):
and that describes a type of outpatient office visit. You
plug that in, you do an Internet search, Google it,
and up will pop some descriptions of that code. And
what you're doing is basically just making sure it sounds
roughly like the services you believe that you were provider,
that you were told by your physician that you were
(19:58):
provided great, and while you're there, you're going to find
what Medicare pays for that CPT code, for each CPT
code for which you're being charged now Medicare. The reaction
I get Joel and Matt often is that people will say, well, Medicare,
(20:19):
that's for old people. That has nothing to do with me,
and I say, well, yeah it does, because Medicare is
the lowest, most fair retail price that is paid for
medical services in the United States period. So that's the
number you're looking for. That's the fair retail price you're
looking to pay. That's the price that shows you're not
(20:41):
being overcharged, overcharged, or upcharge. For instance, let's say you know,
God forbid, you had to go into the emergency room.
You're away a couple hours away skiing and you fell
broke your arm. Go to the nearest emergency room and
they're like, you know what they did the X rays.
You're going to need this set surgically. We'll call the
(21:03):
orthopedis closer to your home. You can go home. I'll
just put you in a sling here until you can
have surgery tomorrow or the day after near your home
with a provider near your home, or who's a network
with your insurance if you have insurance. So you go,
you go home, you get the surgery at the orthopedis
(21:23):
closest to your home, and a month later, you get
a bill and you from the emergency room right when
you're on vacation, and you look at it and you're like, well,
well no, there's no CPT codes here, So you call.
You finally get a real bill that has CPT codes
and you plug them in and one of the CPT
(21:44):
codes says humoral fracture intervention. So it sounds like well,
I don't know what humorous is, but fracture it sounds
like something broken. Okay, But intervention, well, all they did
was put it in a sling. No, they didn't do
an intervention. That's an up charge. There is a CPT
(22:05):
code I'm sure for a sling if they're going to
charge you for that, but they need to delineate that
in the CPT codes. They should not charge you for
fracture intervention. The intervention you had was at your home.
It was not in the emergency room. So that is
getting up charged. That's why you're going to take in
step two. Those CPT codes you work so hard to get.
(22:27):
In step one, google them, do an internet search, find
out what descriptions come up. Make sure it sounds roughly
like the services you had. To make sure you're not
getting double billed or up charged. And while you're there,
find out what the lowest, most fair retail price for
that medical see.
Speaker 2 (22:44):
Okay, so then you've got the procedure, you've got the
price is Step three just basically saying hey, this is
what I would like to pay.
Speaker 3 (22:50):
Yep, Matt and Joel, you guys are always putting ahead. Here,
you got it. Step three is calling back the provider
and saying, hey, yeah, you know that emergency her and
your surgery I have last month and I just got
a bill that the first bill you guys sent was
like ten thousand dollars. But in my case, I am
willing and able to pay three thousand dollars. And you're
(23:14):
not going to share this with you You don't have to
share this with them. It's not of their business and
they don't really care. But three thousand dollars is the
price that you may have come up with when you've
done the three steps against that medical bill. Medicare pays
three thousand dollars for the services you were billed ten
thousand dollars for in the initial bill that was not
(23:34):
a real bill. And you're going to say, you know what, yeah,
I can pay three thousand dollars, and you know what,
that was an emergency. Nobody's prepared for an emergency. I
can only look, you can't get blood out of a stone.
I've tried to turn my budget up every which way.
I can only get fifty dollars a month out of
(23:54):
my budget to pay this. Who can I speak with
who can help me set up an interest repayment plan
for this fifty dollars a month for this three thousand
dollars that I'm willing and able to pay. So Matt
and Joel. People also often when I get to this point,
when I share the example of the three steps, they'll say, well,
(24:15):
three thousand dollars fifty dollars a month, Oh my gosh,
even if they would accept that number, it's going to
take you forever. It will take you forever to pay that, Okay,
So it'll take you sixty months, five years, half a decade.
And the reason why they're going to accept it, it
doesn't matter how long it's going to take. That's what's
(24:36):
in your budget, and that's what you're gonna stick to.
You're gonna stick to your guns. And the reason why,
even though you're gonna get pushback, they've been trained to say, hey,
you know what, we took care of you and or
your loved ones during tough time and saved your life. Yeah,
you're gonna get your money. Yeah, guys, you'll get your money.
I just want to pay what I owe, and this
(24:56):
is what I can pay you, and they don't have
to chase you it costs them money to chase you.
Speaker 2 (25:01):
It's the burglar.
Speaker 3 (25:02):
They know they're saving money. That's why they're going to
accept you're being proactive. They don't have to chase you.
And frankly, they know that their bills are not real
bills to start with. That was a fake number to
start with.
Speaker 1 (25:17):
And if they have to turn it over to collections,
they're going to get pennies on the dollar.
Speaker 3 (25:20):
It's exactly.
Speaker 1 (25:22):
It's not gonna be worth their time.
Speaker 3 (25:23):
Probably right, you hit it right on the head.
Speaker 1 (25:25):
Well, okay, I want to ask you this, doctor Burgee,
because you reference somebody who even with like let's say
a bill of three thousand dollars, Hey, I don't have
the money to pay, and it's going to take me forever.
We can do a payment plan or something like that.
But maybe that's not even the place they need to go,
because what about what about qualifying for our financial assistance?
It seems like from what I've read, something like thirty
to forty percent of Americans, given their income and their
(25:47):
family size, could qualify will qualify for financial resistance either
a greatly reduced overall bill amount or for it to
be completely forgiven. Is that true?
Speaker 3 (25:57):
Yes, sir, you got it. It's true. So, by federal law,
all nonprofit institutions, hospital, medical service facilities, medical care facilities
have to offer to the folks in the communities in
which they operate sliding scale, income based discounts in exchange
for not paying any money in taxes, not paying a
(26:20):
dime in taxes for the hundreds of up to you know,
hundreds of millions of dollars of revenue. So that's a
big deal. By federal law, Yes, they must if there
are a nonprofit facility. And the last numbers I saw
about sixty sixty five percent of hospitals medical care facilities
in the United States are nonprofits. So yes, by federal
(26:41):
law they have to offer that. This is the thing.
Don't think that just because you have a high income
that you won't qualify. So I actually had a case
where the person had a really high income, like I
think her gross income salary was one hundred and fifty
thousand dollars a year, but our medical bill was so large,
(27:05):
I think it was like ten thousand dollars. According to
their formula for this facility, it was it happened to
be an academic facility, which are by definite. Usually I'd
say nine plus out of times out of ten. Their nonprofit,
this particular facility ten thousand dollars one hundred and fifty
thousand dollars growth salary, that sliding scale income based discount
(27:30):
wipe the whole bill away.
Speaker 1 (27:32):
Very nice, but they're not always going to tell you
that upfront, right, So you either have to like ask, hey,
what is your financial assistance policy?
Speaker 3 (27:41):
Exactly? Guys are so sharp. So by law, there's a
law that says they're supposed to post their practices for
offering a financial aid application. You can call it whatever
you call you know, whatever name you want to call it,
financial aid, financial assistance, charity care, whatever you want to
call it. They have to offer everyone an applicationation to
apply for sliding scale income based discounts. And so people think, again, oh,
(28:07):
I make too much money, and well I went to
this other hospital cross town and I didn't qualify. Every hospital, actually,
nonprofit facility even in the same town, have different formulas.
So always always ask. So someone brought this up instead
of doing the three steps, just ask for a sliding
(28:27):
scale income based application, ask for financial aid assistance application.
This is the problem. If you do the math if
you're saying about thirty to forty percent of medical services,
meaning medical bills you're going to get in this country
qualify for required financial aid required federal financial aid by
(28:51):
the government. So that means that sixty percent seven sixty
to seventy percent of the medical bills generating these in
the United States do not qualify for required financial aid.
So you want to do both. So what I usually
do is in those cases, if you know that you
went to a facility that as a nonprofit facility or
(29:15):
an academic facility, ask call theer billing office and ask
for a financial aid application. Once you get the bill,
then you can find out what you owe. If you
have the whole thing wiped away, they don't have to
bother to apply the three steps. But if there's any
money left over, or they don't offer financial lead, or
you don't qualify, then you know the three steps to
(29:37):
make sure that you are getting the You're not i
should say, getting overcharged, you're getting the right bill.
Speaker 2 (29:44):
It's a multi pronged approach, and I think that that's
a great way to think about it. But once you do,
I mean what you're talking about there, once you get
the bill let's say you've kind of passed the stage
where you can apply for that financial assistance. What you're
talking about there is negotiating for it. And one of
the things that you talk about your book to aid
within that discussion that negotiation is what you call a
quote unquote battle journal, which sounds really intense, but I
(30:08):
feel like it also doesn't have to be the super
confrontational thing. It can even just like basically, what you're
doing is you're just trying to provide some organization to
your thoughts. You're trying to provide some organization to discussions
that you've had, Who you've talked to, what date you
had that discussion, what it is that you've learned. I
guess I'm kind of explaining why that's why that's so
important as well, But yeah, I mean, why why else
(30:29):
do you need to have a record of some of
your conversations.
Speaker 3 (30:33):
Yeah, people think that negotiating in whilst something that's aggressive,
or that you have to know fancy words or no
fancy medical terms or be really really smart. No, when
you're doing the three steps, you're automatically negotiating. You just
(30:53):
it's just very matter of fact. It's just going through
the steps and when you call.
Speaker 2 (30:57):
Them surprise you're negotiating. Yeah, you don't eize, you.
Speaker 3 (31:01):
Know, you don't realize that, Hey, I have this hard
number here. They're like, okay, fifty dollars is going to
take us forever to get our money. Can you do
one hundred? No, no, you can't. And let me tell
you why. You're going to stand on your ground again.
If you agreed to one hundred, you're like, okay, maybe
I can squeeze and stretch to one hundred. If you
have a bad month and you can't make that hundred
dollars payment that you agreed to, they can send you
(31:24):
to collections right away. So stick to your guns. Whatever
your number that you come up with, you have to
stick to it. So that's why you want to use
a battle journal. And I felt kind of bad to
your guys's point, I felt kind of bad calling at
a battle journal, But that's what it is. It's kind
of like armor for you because you are documenting every
(31:45):
discussion you have with them. And unfortunately, if something happens
and they try to take you to collection, send you
to collections or god wd, be even worse, you know,
bring a claim against you in court, you have documentation
of who you spoke with and what was said.
Speaker 1 (32:01):
Okay, I want to ask you about best payment method. So,
for instance, let's say you come to an agreement, you say,
all right, I got the CPT codes. I push back,
and now the true bill instead of ten thousand dollars
is eighteen hundred dollars, and I don't qualify for financial assistance,
so I've got to pay it. But I also don't
have eighteen hundred dollars. Some people will just put it
(32:23):
on the credit card to be done with it, paying
interest for months and months and maybe even years to come,
really harming their personal finances and their future. So how
should people pay? How do you agree to pay the
hospital when there is a certain amount you owe and
you feel comfortable now with the final bill, how do
you proceed?
Speaker 3 (32:42):
Yes, you do not want to put it on a
credit card, no matter what. And that's because once you
put it on a credit card, a medical bill on
a credit card, you automatically obliterate all of the federal
protections federal law, legal protections that you have to have
medical debt not show up on your FYCAL score. So
(33:05):
when you make an agreement a payment plan directly with
the facility. I call it, you know, dancing with the
ones that brought you to the party. Keep your medical
bill with the people that provided their service. You want
to do that, because medical bill payments or payment plans,
I should say that are made directly with the provider
don't show up on your fical score. And to your
(33:28):
earlier point, yes, The second issue is once you put
something in a credit card, if you can't make pay
it all off, the interest rates and by the way,
medical or they call them care credit cards are the
same thing. They say, oh, well, we charge you zero
interest for two years. I think I saw one last
year that has like three years of zero percent interest.
(33:49):
If you make the payments and pay it all off.
Well what if you can't. If something happens and you can't,
there you go and those interest rates rack up fast.
Speaker 1 (33:58):
No that makes sense. Okay, well that's great advice. We've
got a few more questions we want to get to
with you, doctor Virgie, including kind of where we go
for help if we're stonewalled with a bureaucracy at a
hospital or a medical facility. We'll get to questions about
that with you right after this.
Speaker 2 (34:22):
We are back. We're talking with doctor Virgie on how
to avoid this crushing medical debt. And before the break,
Joel alluded to this, but are there any government or
nonprofit agencies that can help if we feel like we're
being given the run around, if it doesn't feel like
that we're being given the right information, what can we
do about it?
Speaker 3 (34:43):
So, if you received your care at a nonprofit hospital,
there is a nonprofit organization called Dollar furdal l l
A r f o R dot org and they will
help you work through the process of appealing essentially the
(35:03):
decisions by this facility to not cover you lower your
bill or they say that the care is this price
and not the price that you in your research applying
the three steps discovered with the medicare fair retail price.
So that's one organization there. The organization that I always
(35:25):
refer folks to that's also a nonprofit, will help you
with all medical bills, it doesn't matter if it was
with a nonprofit hospital, and that's called the Patient Advocate
Foundation and that's Patient Advocate dot org. And the reason
why I recommend them is because basically they do almost everything.
(35:47):
They do everything other than up to not including going
with you and representing you in court if you get
taken to court by these unscrupulous, over aggressive predatory providers.
Now there are some for profit companies that will do this.
They'll help negotiate bills down and in exchange they take
(36:07):
ten percent usually as the going number of the amount
that they save you. So I saw one case where
the insurance company refused to pay the eighty thousand dollars
NICK bill for twins because in their records they said
(36:28):
it was not an emergency. Well, when is babies being
born ever? Not an emergency like the right? And they
were sick they needed to go to a NICK So
how is that? How was that elective? Right? So, anyway,
the point is the couple tried to go for months
(36:48):
in between the providers and the insurance company, and just
the conversation and the information and medical rectors weren't getting
passed along. So they got tired. It's a war of attrition, guys.
That's why I called a battle journal. It's real, it's really.
They just wore them down, and so they finally went
to a for profit company that helps resolve these issues.
(37:08):
And so instead of paying eighty thousand dollars, they paid
eight thousand dollars to the company that negotiated the bill down.
Speaker 1 (37:16):
Okay, Yeah, I've seen some of these popping up, and
it seems like for the person who's gotten weary finding
that bill, it might be a decent kind of last solution, right, And.
Speaker 3 (37:26):
I really disagree. Now, if you're really chronically only has
some really big major medical issues and hospitalizations prolonged and
multiple Okay, yeah, but then I would recommend hey reach
out to just try the Patient Advocate Foundation first. But
the first thing I want everybody to know is that
a lot of this foolishness can be just be just
(37:47):
just not become a non issue if you just apply
the three steps.
Speaker 1 (37:52):
Yeah, okay, say that.
Speaker 3 (37:54):
Eight thousand dollars, eight thousand dollars supposed a long way
to a college fund, starting a college fund for twins.
Speaker 1 (38:00):
Right, that's a lot of money too, And we don't
want any how to money listeners paying any dollars more
than they have to be.
Speaker 3 (38:06):
You don't, Oh, that's my point. If you don't know
what no, all.
Speaker 1 (38:10):
Right, you mentioned at the very beginning of your book,
you say that a portion of the sales proceeds go
to this nonprofit called RIP Medical debt, which Matt and
I we've heard of. They have what I think they've
eradicated over a billion dollars maybe.
Speaker 3 (38:22):
Oh gosh, that was last year. Just in lessen a year, guys,
they've gone from over a billion dollars to over seven
billion with a b dollars and medical bills are eradicated
for folks facing bankruptcy from these medical bills.
Speaker 1 (38:37):
And these are all right, these are all medical bills
that have gone to collections and then and then RIP
Medical Debt is saying, listen, for pennies on the dollar,
we're going to eradicate this on behalf of people. So
it feels like it should be something that's unnecessary in
a country like ours, but sadly it's necessary. But I'm
also I think it's great that what you're doing with
part of the proceeds of your book is going to
(38:58):
help ensure that their work continues to to you know,
continue continues to make waves out in the world.
Speaker 3 (39:04):
So for every book that sold, one dollar goes to
our IP Medical Debt, which eradicates one hundred dollars in
medical bills for someone facing bankruptcy from bills medical bills
that have gone to collections.
Speaker 2 (39:18):
Very cool. We love that, We love that that that
is a part of your mission, doctor Virgie. And we
haven't even gotten to everything obviously that you cover in
your book, and so we will link to where it
is that folks can purchase your book, and actually, can
you tell us where it is folks can learn more
about you?
Speaker 3 (39:34):
Sure? Well, first, why don't you just like have me
come back? What's just no part way guys, But if
you want to find out more, Crush medical debt dot
com is the place to start. And I'd like to
send people to Crush Medical debt dot com slash free
dash resources or just go to Crush Medical Debt dot
(39:55):
com and the free resources as on the top of
the navbar there. And the reason is I direct folks
there because that's where you can find a refresher a
checklist of the three steps of the Only Right Way
to Pay every medical bill. So, you know, some people say,
you know what, I really don't even want to spend
money on a book. I've just things are just so tight,
(40:16):
I just know, So go to crushmedical debt dot com
get this information for free, the three steps of the
Only Right Way to Pay a Medical Bill and I'd
say eight to nine times out of ten. You just
eradicate the foolishness that unfortunately predatory billing tries to inflict
on folks and make us victims of the system.
Speaker 1 (40:36):
Doctor Burgie. We love what you're doing out there. You're
making a difference, and thank you so much for joining
us on the show today.
Speaker 3 (40:42):
Oh my gosh, thank you for having me guys. I
love talking with you, and thank you for what you
guys do. You're doing awesome stuff helping folks master their money.
Speaker 1 (40:49):
Oh well, thank you. Like you're in a kind similar
missions I think, like minded for sure.
Speaker 3 (40:54):
Yeah, mutual admiration society.
Speaker 1 (40:58):
Awesome. Well, thanks again, Take care guys, Matt. Always good
to have a swell conversation. There's so much, so much
nuance in this topic of pushing back against you know,
unethical medical billing is sure is one thing, or maybe
just an error prone industry as on top of that,
and there's there's a lot we need to know as
individuals to fight back.
Speaker 2 (41:18):
She mentioned how they never make mistakes in your favor.
Speaker 1 (41:21):
Right, isn't that amazing?
Speaker 2 (41:23):
So if you are out there and you're thinking, oh,
I don't think I want to check in because what
if I'm actually going to owe them more money? That's high,
highly unlikely.
Speaker 1 (41:33):
You never like that community chest of monopoly, right, bank
are in your favor, here's one hundred and fifty bucks.
It's not gonna happen.
Speaker 2 (41:39):
But yeah, what was your big takeaway from our conversation
with doctor Vergie?
Speaker 1 (41:42):
Okay? I think my big takeaway was to use technology
to your advantage. And she was talking about, well, one,
just pushing back getting those those CPT codes, But on
top of that, she was saying, use Google, right, and
Google can help you not only figure out what those
codes mean because it's like a foreign language, but on
out of that you can figure out what is medicare,
(42:02):
pay these medical facilities right for those codes for those services.
And without the Internet and Google at your service, man,
this must have been so much harder back in the day.
Speaker 2 (42:13):
I think it was probably impossible. Yeah, yeah, So.
Speaker 1 (42:15):
It's nice back in the day, nice to know that
you've got technology on your side. There's a lot of
information out there. It's not necessarily right there in front
of your face. You have to dig a little bit,
but a little bit of digging can save.
Speaker 2 (42:25):
You a lot. Yeah, absolutely, and that's important. Information to know.
And so you were talking about figuring out what it
is that Medicare pays. So I guess my big takeaway
is going to be related to that, because obviously it's
not that you're trying to get out from paying a
bill where a hospital or a doctor took care of
you and provided you a good service. You just want
to in what she said and when I wrote this down,
(42:46):
but you want to be able to pay the fair
retail value. And you know what if the government, if
they're the ones saying that, oh, this is a fair price,
well I want that to be a fair price for
me as well, like I don't't have to pay some
marked up right. And so it's not that you're trying
to pull one on the hospital or the doctor or
the clinic or wherever. It's just about making sure that
(43:06):
you're not getting ripped off. And so I guess it's
not just about having the tools and using the technology
and figuring out the CPT codes. But it's not not GPT.
By the way, we're not talking about chat chat CPTs.
Somebody should make a tool.
Speaker 1 (43:21):
That's chat cpt A I can help you push back
on some of this.
Speaker 2 (43:25):
Yeah, that's so so it's not just about the tools,
it's also the mindset and how it is that you
are looking to approach some of these conversations in some
of these negotiations, because if you are not afraid, but
if you're kind of timid about how it is you're
talking to these medical providers, you may not negotiate as well.
If you're thinking, well, they did fix me.
Speaker 1 (43:46):
Yeah, you might think, oh, I got good service. The
doctors and the nurses were great, Like, I guess I
have to pay what I owe, but you should as
opposed to divorce those two things. Thankful for the great service,
but then push back against the bill that's out of line.
And there are specific lines in this that you can
draw based on the information you can get from the
internet from just a little.
Speaker 2 (44:04):
Bit of research.
Speaker 1 (44:04):
So you don't have to feel bad pushing back, especially
because these nonprofit hospitals in particular, have a lot of discretion,
have a lot of ability thought for forgiveness, and actually
legally are required to So yeah.
Speaker 2 (44:16):
Well, she was saying that that's another great point that
I guess I'd never really thought about it, but that
they are required to offer what the an income based
repayment plan. Oh my gosh, that's also some excellent information
to have on hand, Like, these are all things that
should help you to think. Oh no, I don't want
to say that you are owed a discount or that
(44:36):
you deserve a discount, but that is one hundred percent
an option. Yeah, especially if you're like, wait a minute,
I get taxed on what I earn the hospital doesn't
so a little bit.
Speaker 1 (44:47):
I've done this before too, and before I knew that
this is the reason why it was forgiving.
Speaker 2 (44:50):
Them just because I want to save money, like pay
less money.
Speaker 1 (44:52):
I was like naive but just kind of persistent, and
having looked back on those days, I'm like, man, it's
just interesting. I've probably paid other medical bills that I
didn't need to, and I don't want other people to
go through that. I want people to be able to
know their rights, know how they can push back and
get their bills either reduced or forgiven, and fight back
(45:13):
against a system that is really seeking to part them
from their money.
Speaker 2 (45:16):
Yeah, to feel empowered and motivated to do it as well. Yeah,
that's right man. All right. The beer that you and
I we both each enjoyed, a Passo fino porter. This
is a beer by Horsefly Brewing Company out of Montrose.
Is it Montrose? I don't know, it's one word, but
it's it's Montrose, but just one word in Colorado. But
(45:39):
this is a beer from Mark and Caitlin. And so
they actually live in North Carolina and they embarked on this,
he said, eighty six hundred mile road trip that included
a couple of days. Nice.
Speaker 1 (45:51):
I guess at a favorite spot of every road trip
needs to involve a craft brewery or it's not officially
a road trip. Sorry, you just drove your car around
the country, all right, True, you gotta have disc golf,
I think, and craft beer involves. But yeah, big thanks
to him taking that's a Yeah, that's gonna be interesting
Mark and Caitlin, big thanks to y'all. And yeah, this
beer was. It reminded me of like did you dig
get a semi sweet chocolate chip where it was a
(46:11):
little bit bitter, a little bit sweet and not too heavy, right,
So I love a good porter and too heavy.
Speaker 2 (46:18):
Yeah, too sweet, which is kind of exactly what you
want on a warmer summer day like we're experiencing now, right.
Speaker 1 (46:24):
So you get that it's not stout weather yet, No, yeah,
we can do porters.
Speaker 2 (46:27):
If you want some of that roasty flavor, then that's
when you should be looking to something like a porter
where you've got those darker flavors without the body that
weighs you down. That feels like it should. You know,
it's almost like a blanket. You want a nice heavy
blanket in the winter. That's also how I feel about
bigger scouts. If you do what some of that flavor
here in these warmer months, that's when you offer that porter.
Speaker 1 (46:47):
Yeah, the big stouts are December through February. That's absolutely yeah.
Speaker 2 (46:51):
But then again, you know, we'll probably end up with
us some giant stout in like two weeks while it's
still warm.
Speaker 1 (46:56):
You never know. We are equal opportunity drinkers. But that'll
be the that'll be it for this episode. We'll have
links to some of the free resources that doctor Burgie
mentioned up in our show notes at how money dot
com and a link to her book to so you
can check that out.
Speaker 2 (47:08):
Yea, specifically the patient Advocate dot org. That's sounding like
an incredible, incredible site. For sure, you can find all
that up there. But buddy, that's going to be it
for this one. So until next time, best friends out,
best friends out
Hosts And Creators
Joel Larsgaard
Matthew Altmix
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